Developing Your Clinical Instincts with Derek Benz, MS, PA-C, MBA

Featured ThriveAP Faculty Discussion: Derek Benz, MS, PA-C, MBA

At ThriveAP we are honored to have an expansive faculty of expert speakers and APPs with impressive credentials and experience. Today we are talking with one of our esteemed faculty members to gain their advice for thriving in an advanced practice career. 

Derek Benz, MS, PA-C, MBA, joined us to discuss times he has trusted his 'gut' for beneficial results, how he built his foundation that allows for instinctual knowledge, the key to being a good mentor and more. Watch the interview below with Sarah Maxwell, Director of Marketing at ThriveAP and Derek Benz, MS, PA-C, MBA, or read the transcript.

Meet Derek Benz, MS, PA-C, MBA

Interview Transcript

Sarah Maxwell: Hello, my name is Sarah Maxwell. I'm the Director of Marketing at ThriveAP. At ThriveAP, we are honored to have an expansive faculty of expert speakers and advanced practice providers with impressive credentials and experience. Today I'm going take a few moments to get to know one of our faculty members a little bit better and gain some of their advice for thriving in advanced practice career. Please welcome Derek Benz, MS, PA-C, MBA. Derek, how are you today?

Derek Benz, MS, PA-C, MBA: Good, how are you today? 

SM: I'm well, thank you. I'm going to launch right in and ask you to tell us a little bit about yourself. You know, tell us about your background, your practice, where you're practicing at. 

DB: Sure. Well, I originally grew up in Utica, New York, which is dead center of central New York. At that time I went to undergraduate at Ithaca College. I had actually no expectations or thoughts of doing medicine at the time. Thought about doing more therapy or physical therapy, and I was actually doing cardiac rehabilitation at the time in college. I went and did that an internship and realized that that wasn't for me.

Then I just went through a lot of college and realized that wasn't for me. So I was in a panic. What am I gonna do now? As, as you're embarking on getting out of college, I'm like, oh my gosh, what am I gonna do? But I happened to see, during that time, I happened to see a PA that was doing stress tests and outside of lab. I was like, well, that's pretty cool, but I didn't know about this. So I looked into PA. At that point in time, I missed the applications for almost all the schools because it was so late in the game. It was still open at Seton Hall and University of Medicine and Dentistry is where I went and it was still open as a joint program at the time. So at that time, I mean, just showing my age now, I used a brother to do my essays, had to overnight the things to get it in on time. So I went to an interview when my father actually came with me and went on an interview and they you know, did the interview and they said, they accepted me right after my interview, which was like kind of a shocker.

So my father, I come out and just talk to my dad and he's like, so how'd it go? They accepted me. He's like, what do you mean? I'm like, they accepted me.Already? I'm like, yeah. He's like, what are you going to do? I'm like, I don't know. This is kind of interesting, this is so quick and accurate. But people always told me that your profession chooses you. Which it really did. So, you know, I was like, yeah, that sounds good. I'm going to do that. So I went to school and the rest is history. I graduated from Seton Hall University of Medicine and Dentistry back in 1999.

During my last rotation I had an emergency department rotation, loved it. And it's funny cause I was working with a medical director and at that time he didn't have technology, he had books, he had books stuck everywhere. So I remember I saw a patient that had iritis and I, got out of the room and I'm looking it up and I'm trying to figure out what it is and I go up to the medical director and I'm like, yeah, I think this person has iritis, indirect photophobia and all these things. I just looked up and he's like, you know, I think you're right. That's great. Can you call the consultant for me? So he had me call the consultant and he was super impressed. I feel like I swindled them because I looked everything up in a book right outside the room. But they hired me out of there and I've been in emergency medicine ever since. I think it just suits my personality. I'm kind of high paced and I like the variability of what's coming on.

I worked in New York for about five years where I met my wonderful wife at the time she was a ultrasound tech now she's a realtor, but at the time she was doing a travel assignment, she kept re-opting them and then eventually, she was from the Atlanta area and I had a sister living in the Atlanta area. So we came down here and realized the quality of living was, or the price of living was a lot better than where I was. And we decided to move down to Atlanta. So I've been here Since 2004. So I've been practicing since 99, but I've been with Rhode Island Med since 2004. Eventually became the lead over our three hospital system and then progressed to regional director over southeast contracts. That's where I am today an that's how I got there. It's kind of funny when a student asks me how I decided to do what I've been doing, I almost feel bad. I'm like, well, it's not exactly what you expected.

I kind of fell into it, but I love it. I mean, I've been doing it for 24 years now. I think it suits me.The path chose me correctly, I should say.

SM: I think that's actually more real most times, is not everybody has such a cookie cutter, direct path, and you know, what I went to school for was not exactly what I'm doing today. Pieces of it I use, right? But the same thing, the path just kind of chose me. And I was like, gosh, I'm just so passionate about this part of business. I'm so passionate about doing this. And I love this. That didn't exist even when I was in college. You know, when you think about obviously me and marketing, digital marketing really wasn't a thing back then. So that's just finds you.

DB: Sure. Yeah.

SM: And I had a very different experience as far as I was in Cleveland and then came to Nashville. So the cost of living thing was a little bit different for me. A little bit of an opposite flip.

DB: Right?

SM: So you're one of our newer speakers in one of our newer programs, our emergency medicine program, which is really exciting for us to get to launch, especially because we were able to do it in partnership with AAENP. Tell me a little bit about what attracted you to joining the program? What attracted you to working with ThriveAP and being a part of Transition to Practice and the way that we do it?

DB: Well, I think it's interesting. I mean, I like the education of APPs, I think it's a great opportunity to give back. When I was a student, it was just so nice to have someone that would take the time because some people are just sponges.They just want to take it all in. And that's something that excites me, when you have someone like that. You don't realize how much you know, until you get a student. And you start thinking, you start talking and talking and talking and realize that they don't know even the basis sometimes of things. It's amazing when you take that time and start really verbalizing it out loud, like, "man, I guess I do have something to offer." Where when sometimes you don't have a student or somebody that's that eager, you might not realize how much you have to offer. And most people with experience, they do, but they just don't realize it at the time.

And I think it's also nice to get people that are fresh and eager to listen and learn. It kind of helps people along their educational journey, especially, you know, people that are new to that. I think that's great, but it's also nice when you have students just to have that interaction.

You find out what you don't know, too. Someone will ask you something and, it's like, "Hmm, I don't know, but let's figure that out together." Or, you know, "Well, go look at this and tell me about it tomorrow." I don't do that to people. But it's like, hey, why don't we both look this up and try to figure it out. "See, that's a great question. I just don't know the answer." It keeps me on my toes, keeps me current, making sure I'm checking out the most current things as well. So I think that's what kind of brought me to the idea of doing some education as well. It's mutually beneficial in that way.

SM: So in your career, I think you said 22 years, 25 years, 24 years now.

DB: 24. That's probably why this is, that's why you got this shining over your light off my head right now. 

SM: You know, the grays are coming in. I get it. I get it. During that time, you know, I mean, 24 years, that's a good amount of time, what is something that you would pinpoint as being one of your more noteworthy career accomplishments or something that you're just really proud of? 

DB: You know, I think this is probably going to be quite different than most people. I really think it's kind of just the clinical gestalt that you've developed over time. Sometimes you just walk in a room and you know, "Hey, something's not right." Or you just might pick up on something that normally you wouldn't. It's being able to use that and help people on their time. You'd like to help someone, a friend, for example, this, this is my noteworthy accomplishment, probably different than most people, but this is what's noteworthy to me.

And what made me feel good about things, I had, a friend, my daughter's friend came into the emergency department, a little girl at the time. Scared. But, you know, short of breath, has asthma. She's just not breathing, she's not getting better. You know at times, from all the literature, let's not do X-rays on these asthmatic kids. You don't want to expose them to the radiation. But you know her O2 was okay, it wasn't perfect, she had a little pain in her chest and it just wasn't right. You know, all things lead to you probably shouldn't do an x-ray on this kid, you know, treat her, send her home. But if you ever practice medicine, if something's going to go wrong, it's going to go wrong with somebody you know.

So yeah, you know, something's just not right. I'm going to do that. I want to do an x-ray on her. I'm talking to the parents. I know the parents. So I do an x-ray, this little girl has a pneumothorax which is a collapsed lung, so this poor little girl, she's going to need a chest tube, she's going to need to come in the hospital, so it's just a poor thing to talk to the parents, and she's scared, but you get everything taken care of, and she's taken care of, and that's not my noteworthy accomplishment. My noteworthy accomplishment was two weeks later, I go to my daughter's school, I would do science experiments with the kids and stuff like that. She comes up and gives me the biggest hug that's my noteworthy accomplishment, that she comes up, gives me this huge hug.

"My noteworthy accomplishment was two weeks later, I go to my daughter's school, I would do science experiments with the kids and stuff like that. She comes up and gives me the biggest hug that's my noteworthy accomplishment" - Derek Benz, MS, PA-C, MBA

My daughter's kind of looking at me like, that's kind of odd, other kids will give me high fives and other things like that, but it was different. She noticed it was different, but she didn't know that I took care of her because of HIPAA. Later on, the parents, were talking when the girls were around and then my daughter kind of put it together.

That's noteworthy to me, just helping someone and it was like pure that she was thankful. It was just something that was pure. That's my noteworthy accomplishment. It's not anything that I've accomplished through work or degrees and all that. It's that, that's what's comfortable to me.

SM: That's powerful. That is different than what I normally hear. That's really meaningful. You got to see the whole process too, right? Having that connection, seeing that, usually I would imagine, it's emergency medicine specifically too, they leave and then that's kind of it, but in this case, you got to see the real impact that you made on her life and her parents' lives.

DB: It was, like I said, it's probably different than most people say, but that's more accomplishment than any degrees or letters after your name.

SM: That's beautiful. With that, that might lead into this, what is your greatest passion in your career and in your role?

DB: You know, I have a passion. I do, I still love taking care of patients clinically, that's the opportunity once again to take care and it's always rewarding me to take care of people. I mean, another random story.

This is recently, I was working and about to be done with my shift, a friend called me, "Hey, my dad's coming in," and I know him, I'm friends with him, so it's not like I didn't know him. So I'm like, "Oh yeah, I'll check on him." Just check on him, make sure he's okay. So check on him. He's had some cardiac issues, but he looks fine. He gives me a big hug, we're talking about things, he looks fine. I'm like, yeah, let's get some things taken care of and of course I'm not going to leave now, I'm about to leave my shift. So I'm sitting there talking to him, then I go out and things are getting settled. I know his history. He's got a pretty strong cardiac history. I go back in the room to check on him, and he is... 180 degrees different. I'm like, Oh my gosh, he looks terrible. He's crumping. I'm like this person, I know, the EKG initially came back as normal.

Is EKG still normal?

I mean, let's repeat EKG. Go quick, quick EKG still normal.

But you know, because I know his history. A cardiologist doesn't want to come in at this point in time. They don't because EKG is normal. But you know, sometimes you just have to advocate for your patient, and of course, someone you know, I'm obviously pushing harder. But we get him to come in, he goes to the cath lab, got a good extent, he has real disease, what's really going on. Those are things that give me passion, you know, taking care of somebody and making a difference, you know, and...

It's more impactful when it's somebody you know, but still it's just something, that's what gives me a passion. Also not just that, I really like the underserved population that comes in the emergency department because they're so appreciative of what you do. I mean, some people come to the emergency department, they don't have any other resources. They have nowhere else to go, but they're so appreciative when you take care of them. You know, so I do like taking care of the underserved population as well.

And as well as, you know, students that come in. It's nice to give back. I think we talked about that. That's another passion to be able to mentor students and bring people along and help them in their career. I'm speaking a little bit about supporting and mentoring APPs.

SM: What would you say are the good attributes or attributes people should have or look for in a mentor?

DB: Patience. I think you need patience. Patience from, from the mentor, but from the student also. Sometimes you can't give them an answer right away. You know, I'm not a walking encyclopedia, so patience on their part, but on my part as well. And realizing that everybody has different levels of experience. And everybody's had a different level of engagement. Some people, they're just going to soak everything up.You love being around them. You love talking to them. And some, you have to pull it out of them. You're like, okay, come on, let's do this. I know you've got more questions than this. Let's throw them out at me. "What do you think about this?" Sometimes you've got to stimulate the questions.

So I think that's, it's patience, but also knowing that everybody's different, and how you have to pull something out of them. Because, there's questions. And you know it on their face. Sometimes you've got to pull it out of someone. Some people you've got to save. Some people, they'll bring them all up.

They're great. But also It's knowing what you don't know. That's the other thing. You don't always have the answers. And it's okay. I think it's always okay to say I don't know if someone asks a question. You know, but, the good thing is, in the age of technology, you don't have to pull out the old Tintinalli's, which is the old emergency medicine book. You just pull it up on the web and find out where you can find things and it's always nice to be able to learn together with students, especially students that are close to the end of their rotations. Sometimes I get new cutting edge things that maybe I'm not as abreast on, you can always learn together. When you're mentoring someone, it's a two way street. I'm learning too.

"When you're mentoring someone, it's a two way street. I'm learning too." - Derek Benz, MS, PA-C, MBA

SM: It's like we said earlier, they weren't teaching 90% of what I do today in my everyday job when I was in college. The next generation has that that kind of, I don't know, privilege, I guess, of learning what's going on today. Then we get to benefit from that too, but then they also get to benefit from your years of experience and knowledge that they just don't have.

So when we're talking about not being a walking encyclopedia any longer what are some of the key journals or apps that you use to make sure you are staying abreast of the latest and the best new trends that should be implemented in an emergency?

DB: Uptodate, that's the best, I mean, that's where my lecture stuff comes from. That's where it's up to date. I mean, it's in the name. So anything you can find, it's all the latest research, latest information. Most hospitals will have, I don't know, the hospitals that I'm a part of, have it where you can look it up. They want you to be up to date, obviously. Plus you get CME when you're looking things up, which is great because, everybody needs to CME. If you can do it when you're looking things up in real time, that's great. Hands down, that's the best thing. Other things I like is an app, actually, in one of my upcoming lectures, I have a lot of screenshots from an app. Well, it's not the app, but it's a computer version of MDCalc. There's a lot of things we use now that are evidence-based medicine and decision making tools in the emergency department that you can use that can decrease your liability, decrease your chances of any kind of litigation because you're using the most up to up to date, and using evidence-based medicine, like these calculators, there's tons of them out there.

You just got to know which ones are for your specialty. I mean, emergency medicine, there's tons of them out there. I just love those calculators. I mean, because you can reference them in your chart, you can utilize them, and you can know who is safe to send home, who needs to be admitted, or at least have good evidence-based medicine that you can discuss with the patient and make shared decision making.So those are my, those are my favorites.

SM: I've heard UptoDate a lot, but the second one is a new one.

DB: Yeah, MDCalc, that's wonderful. We'll pull it up, it's an app, and it's a great app to have, or it's on a computer based. There you go.

SM: Well, I always like to end with the same question because I think it's one of the more powerful ones. If you could give any advice to the future. What advice would you give them?

DB: Start early look at everything. Look at every EKG. Sometimes - because nowadays, EKGs come with reports on them, X-rays comes from radiologists, in the emergency department - look at them, get used to them. Cover up the EKG interpretation, interpret it yourself. Look at the test X-ray, interpret it yourself. Look at it, look at every X-ray, look at the CTs. Because when you get used to seeing those, the more you see, the more normals you see, look at the more normals so when you see an abnormal, it's going to jump out at you. You might not know what it is, and that's okay, but you know it's not normal, and you know you'd have to look up somewhere.

So I think that's so important, and listening to every patient. Listening as in, put your stethoscope on them, listen for murmurs, listen to the lungs, listen intently, it's so easy nowadays to, with EKGs and everybody being hooked up to the monitor to, to x-rays, lot of times, physical exams kind of almost becoming passe', which it shouldn't be. The more you do, the more you look at normals, you might share your lung exam, and think, "wait a second, something's wrong here. That's not right. I'm not used to that." The more you hear normals, the more those abnormals are going stand out to you.

And then what's also important, I think, is you need to put yourself in the patient's shoes. Your patients don't want to be there. 90% of the patients don't want to be in the emergency department. Put yourself in their shoes. I mean, have some empathy. You've got to understand they don't want to be there. And then treat them as if that's your family member.

Is that your family member? If it was, how would you want them being treated? Treat them as you would want a family member treated.

Finally, if you're looking for advancement, say yes. Just, when you get involved, say yes. Someone can, say, "hey, can you help me work on a project for front end management?" Yes.

Can you see if we can do this? Yes.

How do you, if you want to advance in things, get involved, say yes. Especially when you're young, you have the time. Those are all my words of wisdom.

SM: I think all of those tips kind of speak to what you were saying earlier about, I just felt like there was something more, they say not to do this, but I wanted to do the x-ray.
Your intuition was telling you to do that next thing and to take this extra look and it turned out to be correct. Doing all of those things that you just said early on in your career are how are you going to get that experience to develop that intuition and that gut instinct to say, "no, I'm going to advocate. I know that there's more here that could be done. So that's how you develop it." I think those are wonderful tips and suggestions for how people can be better clinicians, have better patient outcomes, and move further in their career to reach their goals.

DB: I agree. Well, thank you so much for joining us today and taking time out of a very busy day to chat with me and allow us to get to know you a little better.

DB: Oh, you're welcome. Thanks for the time. I appreciate it.

SM: Well, and thank you everyone else for joining us and stay tuned to meet more of our faculty. Have a great day, everyone. Take care.

More About Derek Benz, MS, PA-C, MBA

Derek Benz, MS, PA-C, MBA has a long and distinguished career in healthcare.  Serving for over 24 years as a Physician Associate in Emergency Medicine. He began his journey at Ithaca College in southwest NY, then went on to further his education by attaining a Masters of Science as a Physician Assistant from Seton Hall University / The University of Medicine and Dentistry of New Jersey where he graduated with the highest of honors. Derek Began his career in Good Samaritan Hospital in Suffern, New York then moved to the metro Atlanta area in GA, to work in the Northside Hospital System, where he achieved many awards including Provider of the Year, Top in Customer Service, and Patient Care Excellence. He furthered his education by attaining a Master of Business Administration from Benedictine University. Served for years as the lead APP for Northside Emergency Associates. Dereka is currently an APP Regional Director of the East for Envision Physician Services. He has a passion for education and helping those new to the profession to achieve their educational goals. 

We are truly honored to have faculty of Derek's caliber in our unmatched expert network. If you're interested in learning directly from experts, like Derek, apply for the ThriveAP program today!